| Evan Taylor Wythe, MD | |
|
20103 Lake Chabot Rd, Castro Valley, CA 94546-5341 | |
| (209) 342-2300 | |
| (209) 524-4240 |
| Full Name | Evan Taylor Wythe |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 44 Years |
| Location | 20103 Lake Chabot Rd, Castro Valley, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013908433 | NPI | - | NPPES |
| 00G522840 | Medicaid | CA | |
| 00G522840 | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | G52284 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chinese Hospital | San francisco, CA | Hospital |
| Seton Medical Center | Daly city, CA | Hospital |
| Regional Medical Center Of San Jose | San jose, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Solano Gateway Medical Group, Inc. | 5496725418 | 15 |
| Cep America - California | 6103739131 | 1093 |
| California Emergency Associates A California Medical Corporation | 9830426295 | 14 |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
| Entity Name | Eden Emergency Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891786240 PECOS PAC ID: 7012802333 Enrollment ID: O20040217000163 |
| Entity Name | Emergency Physicians Associates Overhead Operating Account Dennis Belo |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013969153 PECOS PAC ID: 0547230708 Enrollment ID: O20040727000859 |
| Entity Name | Solano Gateway Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952344293 PECOS PAC ID: 5496725418 Enrollment ID: O20040916001355 |
| Entity Name | Siskiyou Hospital Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1093892275 PECOS PAC ID: 1254223134 Enrollment ID: O20071213000624 |
| Entity Name | Southern Humboldt Community Healthcare District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003819376 PECOS PAC ID: 8820982879 Enrollment ID: O20100106000632 |
| Entity Name | Big River Emergency Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033501168 PECOS PAC ID: 2466764303 Enrollment ID: O20150706002430 |
| Entity Name | Emergency Physicians Associates San Jose Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306311576 PECOS PAC ID: 8921344292 Enrollment ID: O20190107003386 |
| Entity Name | California Emergency Associates A California Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437611936 PECOS PAC ID: 9830426295 Enrollment ID: O20190807002329 |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Taylor Wythe, MD 4301 Northstar Way, Modesto, CA 95356-9262 Ph: (209) 342-2300 | Evan Taylor Wythe, MD 20103 Lake Chabot Rd, Castro Valley, CA 94546-5341 Ph: (209) 342-2300 |
Thomas Eales, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-727-3320 Fax: 317-963-5394 | |
Dr. Emily Rose Nelson, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 651-249-4082 | |
Adria Simon, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-727-3015 Fax: 626-623-1227 | |
Dr. Rahim James Sharifi, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 20101 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-247-6300 | |
Dr. Nicholas Lang, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 510-537-1234 | |
Ralph James Damato, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 20103 Lake Chabot Rd, Castro Valley, CA 94546 Phone: 209-342-2300 Fax: 209-524-4240 |